Cellular and antibody-mediated rejection processes and also interstitial fibrosis/tubular atrophy (IFTA) lead to allograft dysfunction and loss. The search for accurate and specific diagnostic tools is still ongoing and essential for successful treatment of renal transplanted patients. Molecular markers in blood cells may serve as diagnostic tools but studies with high patient numbers and differential groups are rare. We validated the potential value of several markers on mRNA level in 155 blood samples from kidney transplanted patients under standard immunosuppressive therapy (steroids±mycophenolic acid±calcineurin inhibitor) with stable graft function, urinary tract infection, IFTA, antibody-mediated rejection (ABMR), and T-cell-mediated rejection (TCMR) (Borderline, tubulo-interstitial (Banff I) and vascular rejection (Banff II-III)) applying RT-PCR. The mRNA expression of RANTES, Granulysin, GranzymeB, IP-10, MicA and InterferonGamma in blood cells did not distinguish specifically between the different pathologies. We furthermore discovered that the mRNA expression of a specific Interleukin is significantly lower in samples from IFTA patients than in samples from patients with stable graft function (p<0.001), ABMR (p<0.001), Borderline TCMR (p<0.001), TCMR Banff I (p<0.01) and TCMR Banff II/III (p<0.01). There was no statistically significant difference in Interleukin expression between samples from patients with IFTA and urinary tract infection. The measurement of the specific Interleukin mRNA in blood cells distinguishes clearly between IFTA and other complication after kidney transplantation and could easily be used as diagnostic tool in the clinic.

CITATION INFORMATION: Matz M, Lorkowski C, Wu K, Neumayer H.-H, Mashreghi M.-F, Budde K. A Selective Biomarker in Blood Cells Identifies IFTA After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).

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